Individual
ADEBIMPE IBITAYO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS, MS
Contact information
Practice address
106 ROSE GDN, UNIVERSAL CITY, TX 78148-3422
(210) 658-2251
Mailing address
106 ROSE GDN, UNIVERSAL CITY, TX 78148-3422
(210) 658-2251
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2901019446
MI
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
25003
TX
Other
Enumeration date
05/18/2007
Last updated
10/01/2018
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